Facility Evaluation Report

Licensing Program Analyst (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit at 9:55 a.m. Upon arrival LPA was greeted by front desk receptionist and explained the reason for the visit. LPA met with Administrator, Evelina Papzyan and the reason for the visit was explained.

At approx. 10:00 a.m. LPA Mosley along with Administrator conducted a tour of the physical plant to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The following was noted: Facility is a three -story residential building consisting of 30 bedrooms, a commercial kitchen, dining room, television room, lounge and a staff break room on the first floor. The second floor has 36 bedrooms, dining room, library and television room. 16 bedrooms out of the 36 bedrooms are designated for the dementia / memory care unit. The third floor has 37 bedrooms. The facility is fire cleared for 63 Ambulatory, 112 Non-ambulatory and 20 bedridden residents. Delayed egress is approved for the dementia unit. Hospice waiver for 4. LPA observed fire extinguishers throughout the facility, which were fully charged and last serviced on 1/11/2024. The Administrator provided a fire alarm testing and inspection report done on 12/04/2023 where all smoke alarms and carbon monoxide detectors were tested and functioned properly. The facility has their upcoming inspection scheduled for this week. The last emergency disaster drill took place on 09/30/2024 and are conducted quarterly. LPA observed all required postings adjacent to the entrance area. The facility serves residents with dementia, the auditory alarms on the exit doors of the dementia /memory unit were tested and functioned properly at the time of visit. Activities observed on both units.

(PAGE 1) Report Continued on LIC 809C PAGE 2...